Objectives: There are known barriers to advance care planning practices for both health care providers and patients. Since physicians were the main occupations that introduce ACP, the goal of this study was to clarify where the difficulties were felt in the practice of ACP by looking back on the practice of physicians who were working in a designated cancer hospital. Methods: Semi-structured interviews were conducted with 10 physicians who were recommended by the palliative care team as physicians who clinically practice ACP for cancer patients. Interviews were transcribed verbatim, coded, and analyzed using content analysis by Graneheim et al. Results: We finally classified into 6 major categories as follows: Insufficient readiness of patients/Insufficient readiness of medical staff/Discrepancy in communication/Lack of evaluation index of ACP/Dilemma with professional ethics. Conclusion: Patients and health care providers each lacked readiness for ACP, and physicians found it difficult due to the resulting communication discrepancies and lack of colleagues with whom they could collaborate.

Purpose: We held workshops (WSs) that recommend the use of advance care planning (ACP) for medical and health care professionals, and clarified whether or not these WSs motivated them to engage in their own ACP using two indicators: the proportion of professionals who wanted to conduct ACP and changes in the Death Attitude Inventory (DAI). Method: After the WS, we divided participants into two groups, depending on whether or not they wanted to have end-of-life discussions with their family and loved ones. The changes in the DAI brought about by the WSs and their impressions of the WS were compared between the groups. Results: A total of 91 participants were analyzed, of which 42 (46.2%) wanted to have end-of-life discussions with their family and loved ones. In both groups, “afterlife view” and “death anxiety and fear” in the DAI were significantly reduced after the WS when compared to attitudes from before the WS. In the group which wanted to have end-of-life discussions, “death avoidance” (effect size −0.42) and “sense of purpose in life” (effect size 0.51) changed significantly and positively. Conclusion: About half of the participants wanted to perform ACP after having attended the WSs, apparently due to an increased sense of purpose in life and a reduced death avoidance.